Provider Demographics
NPI:1902809510
Name:OHADUGHA, GODFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:GODFREY
Middle Name:
Last Name:OHADUGHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40908
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28309-0908
Mailing Address - Country:US
Mailing Address - Phone:910-609-6448
Mailing Address - Fax:910-609-7040
Practice Address - Street 1:6387 RAMSEY ST
Practice Address - Street 2:SUITE 210
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-9420
Practice Address - Country:US
Practice Address - Phone:910-609-3920
Practice Address - Fax:910-321-6221
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29016207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89128K8Medicaid
NC2284554BMedicare PIN
NCH32937Medicare UPIN
NC89128K8Medicaid
NC2284554DMedicare PIN
NC2284554CMedicare PIN